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Mental illness could strike more of us in 2013 than ever before. But don't blame the strain of modern living: changes to diagnostic guidelines mean unprecedented numbers of people could be taking psychoactive drugs.
In May, the American Psychiatric Association will publish the latest edition of its diagnostic manual, known as DSM-5. Changes to the text approved in December mean, for example, that some people grieving after a bereavement could soon be diagnosed with depression. And Asperger's syndrome is to be subsumed into autism spectrum disorder.
That change is likely to decrease the number of children diagnosed with some form of autism, because not all those who might have been diagnosed with Asperger's would meet autism criteria. But overall, critics fear an expansion of the boundaries of mental illness. "The phrase I use is the 'sickening of society'," says Frank Farley of Temple University in Philadelphia, Pennsylvania, one of the organisers of a petition that tried unsuccessfully to open DSM-5 up to wider scientific review.
Some 20 per cent of US citizens have experienced a diagnosable mental illness in the past year. How this figure will now change is unclear - for the most part the implications for rates of diagnosis haven't been studied.
Allen Frances of Duke University in Durham, North Carolina, led the last DSM revision in 1994 and has been a fierce critic of DSM-5. He fears drug companies will scent a marketing opportunity. Already, he says, "antipsychotics are being giving out like candy".
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